Central nervous system metastases in epithelial ovarian carcinoma.

With the advent of systemic chemotherapy capable of controlling metastases at most sites, central nervous system metastases are becoming more common in patients with epithelial ovarian carcinoma. A retrospective epidemiologic review at The University of Texas M. D. Anderson Hospital and Tumor Institute revealed central nervous system metastases in 13 of 4456 patients with epithelial ovarian carcinoma (0.29%) registered between 1944 and 1984. No patients were identified as having central nervous system metastases before 1968. The median survival overall was 29 months; following the diagnosis of brain metastases it was five months. Five of eight patients treated for central nervous system metastases lived ten months or longer. Patients with isolated metastases to the central nervous system lived longer than patients with accompanying systemic metastases. Patients treated with surgical resection lived longer than those who did not undergo surgery. With surgical resection, postoperative irradiation, and systemic chemotherapy, significant symptomatic improvement and long-term remission are possible.